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The In-Between: Unforgettable Encounters During Life's Final Moments

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Passionate advocate for end-of-life care and TikTok star Hadley Vlahos shares moving stories of joy, wisdom, and redemption from her patients’ final moments in this “brilliant” (Zibby Owens, Good Morning America ) memoir.
 
Talking about death and dying is considered taboo in polite company, and even in the medical field. Our ideas about dying are confusing at Will our memories flash before our eyes? Regrets consume our thoughts? Does a bright light appear at the end of a tunnel? For most people, it will be a slower process, one eased with preparedness, good humor, and a bit of faith. At the forefront of changing attitudes around palliative care is hospice nurse Hadley Vlahos, who shows that end-of-life care can teach us just as much about how to live as it does about how we die.
 
Vlahos was raised in a strict religious household, but began questioning her beliefs in high school after the sudden death of a friend. When she got pregnant at nineteen, she was shunned by her community and enrolled herself in nursing school to be able to support herself and her baby. But nursing soon became more than that when she focused on palliative care and hospice work, it became a calling. 
 
In The In-Between, Vlahos recounts the most impactful experiences she’s had with the people she’s worked with—from the woman who never once questioned her faith until she was close to death, to the older man seeing visions of his late daughter, to the young patient who laments that she spent too much of her short life worrying about what others thought of her—while also sharing her own fascinating journey.
 
Written with profound insight, humility, and respect, The In-Between is a heartrending memoir that shows how caring for others can transform a life while also offering wisdom and comfort for those dealing with loss and providing inspiration for how to live now.

288 pages, Hardcover

First published June 13, 2023

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Hadley Vlahos

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Displaying 1 - 30 of 2,254 reviews
August 20, 2023
Review DNF. This is unreadable to me for two reasons. The first is that author, as a new hospice nurse, is surprised when a dying patient is talking out loud to her dead sister who is apparently in the room. They are, she is told, making arrangements for her to go over to the other side. None of the other nurses seem at all surprised by this as it is a very usual occurence.

Reading this I was prepared to carry on although that means the author, the patients and perhaps the medical staff are approaching this from a religious point of view. What about those who don't actually think there is another side or that people come back to help a dying person get there?

The second reason is that some of it reads like a bad YA novel. The author finds a Physical Therapist very attractive, seeing "his muscles even under his scrubs. He had a unique look, which I later came to understand was the result of his Greek Japanese heritage." So she gets an introduction, they are both shy, a hospice patient watching decides to fake an accident in order to get them together.

The next patient (each chapter is a patient) is the dying Ms Sue. The priest, whom the author had known years earlier, comes for her last ceremony (last rites? It isn't named) and the author says she is dying to tell him her story about her boyfriend (the Physical Therapist) whom she wants to marry and how she had a baby when she was a teenager whom she was supporting alone, but realises the time isn't right.

Ms Sue says that her late husband is there to get her, and she would be leaving - dying - that night. And the author wants to talk about her boyfriend...

The next chapter, Ms Sandra, has a long passage of when the author met her boyfriend's parents for the first time.

Tales of hospice and romance are genres do not mesh. This is not what I signed up. DNF.
__________

Reading notes In between life and death, what people say, how they act, what they want from the perspective of a very young hospice nurse - she is only 30 now - who always wanted to be a writer.
Profile Image for Anna Holt.
52 reviews
September 27, 2023
This is in response to another person’s dnf review. I can’t comment on their review since we’re not friends but I don’t want what I wrote to go to waste.

I just finished it. It all comes together. The author grows and matures in her personal and professional life from the experiences in caring for her patients. She also addresses how she helps patients with no religious backgrounds, expanding on what the end of life journey looks like for secular people. I toe the line between atheism and agnosticism, btw, and frankly have a hard time with faith-based books. I wouldn’t consider this faith-based but religion does come up a lot, understandably. I was ok with it in this context.
Profile Image for Hopeless Romantic.
109 reviews16 followers
March 25, 2023
I'm afraid my review won't do THE IN-BETWEEN justice. Reading these true stories of these patients nearing the end of their lives, I was incredibly profound and moving on a deep level. I so loved and appreciated that the spirituality aspect played in big part in this book, evidence of how undeniable, serendipitous, mind-blowing, comforting, beautiful, and "perfect" it is. I had goosebumps the whole time. I was in awe of the nurse/author Hadley Vlahos and in awe of her hospice patients... of their strength and love. So much wisdom, beauty and love to be shared in their final moments. Out of the twelve patients Hadley writes about, there is a wide diversity in class and religious and spiritual beliefs, yet they all die in the same way - in which that they experience death. I liked how the author shares not just the day to day life of a hospice nurse but how it affects her personal life and her life prior to leading her to become a hospice nurse. The tributes to the patients and the lessons Hadley learns from them was a beautiful end to such a beautiful book. Book doesn't seem even the right word to use, because it's so much more than that. It's life. May everyone have the chance to read THE IN-BETWEEN.

Much gratitude to Random House Publishing Group - Ballantine and NetGalley for the ARC!!
Profile Image for Christy.
4,014 reviews34.4k followers
August 15, 2023
3.5 stars

As a nurse who has worked with many hospice patients (I mostly work with dementia patients) there were parts of this book I really loved and would highly recommend. I think so many people don’t understand what hospice truly is and what the nurses/aides do. It’s such an important job and I give all the props to Hadley for being in this part of the nursing field. I was thrown off by the talk of sympathy and empathy because she got those so backwards which is strange to me. There are parts I loved, parts I didn’t love, but overall I did like this one.
Audio book source: Libby
Story Rating: 3.5 stars
Narrators: Hadley Vlahos
Narration Rating: 4 stars
Genre: Nonfiction
Length: 7h 19m
Profile Image for Valeria.
1 review1 follower
June 28, 2023
What sets "The In-Between" apart is Vlahos' ability to convey the essence of these encounters with such authenticity and tenderness. The link to the audiobook can be found here The In-Between: Unforgettable Encounters During Life's Final Moments . Through her vivid and evocative writing, she paints vivid portraits of the individuals she encountered, giving them a voice and honoring their unique experiences. I was deeply moved by the genuine humanity and raw emotions that permeated each story, reminding me of the importance of embracing the present and cherishing our connections with others.

Vlahos' storytelling is not only emotionally compelling but also thought-provoking. She seamlessly weaves her personal reflections and insights into the narratives, inviting readers to contemplate the meaning of life, the nature of existence, and the profound impact we can have on one another. Her ability to distill complex emotions and existential questions into accessible and relatable prose is truly remarkable.

"The In-Between" is a book that imparts wisdom and deepens our understanding of the human experience. It reminds us to approach life with empathy, compassion, and a willingness to embrace the moments that often go unnoticed or overlooked. Vlahos' writing serves as a poignant reminder of the beauty and significance that can be found in the simplest of encounters.

This book touched me on a profound level, leaving an indelible mark on my soul. "The In-Between: Unforgettable Encounters During Life's Final Moments" is a testament to the power of human connection, the resilience of the human spirit, and the beauty that can be found even in the most challenging of circumstances. I highly recommend it to anyone seeking a deeply reflective and transformative read that celebrates the inherent dignity and humanity that exists within us all.
Profile Image for Addy.
19 reviews
August 21, 2023
all other nurses/healthcare professionals = bad; the author = good. As a nurse wanting to go into hospice but currently working inpatient, I honestly found the perspective offensive. Not all inpatient nurse stereotypes are true, but this book functions on the assumption that they are.

Also — how does a hospice nurse mix up the definitions of sympathy and empathy (p. 237-238)? The writing style sounded like a middle school essay, which didn’t bother me but didn’t help my overall opinion of the book.
Profile Image for Sarah Edell.
5 reviews
July 18, 2023
If you follow other hospice workers on the socials, nothing she shares here about dying is new. The author’s accounts of her patients are well done, and many images stay with the reader. But the author takes a constant humble-brag approach that becomes stifling. Ok we get it- everyone loves you because you are so XYz different from all the others. But really?

Ultimately, I distrust her narrative. She uses many superlatives and constant mentions of being “shocked”, none of which I buy. She tries to wrap every story up with with bows, and the character “Steve” takes on the Jesus character of all seeing, all wise and, frankly, all annoying.

This author will have an incredible story to tell because she does colour outside of the lines, but right now she oversimplifies herself. She needs to keep writing, but let go of the arcs, Steve characters, morals, and cherries on top. Deeper dive. Till then, this is reader’s digest versions of bigger realities.
Profile Image for Cindy.
611 reviews19 followers
May 30, 2023
This book wasn’t exactly what I expected. I expected to read many stories of hospice patients and the experiences the patients and the hospice nurse had during their time of passing. Instead there was some of that and there was way more about the author’s life some of which was relating to her patients. That didn’t make the book bad by it did make it a different type of read.


Thank you to netgalley for providing me with an early release in exchange for a fair and honest review.
Profile Image for Kris Zeller.
888 reviews4 followers
September 24, 2023
Hospice Nurse Hadley beautifully weaves the story of how she found her calling with some of her most memorable patient experiences in this unique memoir about the end of life experience.

In May of 2020, my Grandmother was sent to hospice. She held on for a few days before passing on July 13th.....27 years to the day after my Grandfather passed. A few days later, I was on TikTok for the distraction when I randomly saw Nurse Hadley talking about how patients frequently seem to deliberately choose the day of their passing. I followed Nurse Hadley and have seen so many of her videos about various experiences. So, when I saw she had a book coming out, I pre-order it immediately.....but then I saw it on NetGalley and was so excited to get it a few weeks early!!

I wasn't sure if being an amazing TikTok creator (even one with 1.4+ million followers) would translate into being a good author, but this book was unputdownable. That's an especially impressive.feat given the subject matter. You would think that a book about someone witnessing so much death would be difficult to read, but I blew through it in a day. Much like her TikTok content, Nurse Hadley's book provides anecdotal proof of the afterlife that's hard to argue with. A skeptic at heart, I certainly understand how people would dismiss these types of experiences as flukes or hallucinations. However, having had the unfortunate experience of seeing two of my loved ones in hospice care in recent years, I have also seen these things firsthand, and I found it oddly comforting to read a professional's experience with them.

Nurse Hadley's storytelling is sweet and reverent without being religious. It explores the concept of what happens after death without presuming provide a definitive answer. It's entertaining without being disrespectful to the patients. Most importantly, it manages to tackle a really heavy topic with hope. I am so glad to have come across Nurse Hadley's TikTok and this book, and I sincerely think that there are so many people out there struggling with crippling loss over the last few years that would take comfort in these stories.
June 17, 2023
I read this book in 24 hours. Had I not had to work today, I would have read it in one sitting. I cannot recommend this enough for anyone with a curiosity or fear of dying. The only experience I’ve had with hospice was in January of 2021 when my mother in law ran out of treatment options for her breast cancer and it in turn ran rampant through her body. From the first call telling us the scans were bad and suggesting hospice, I went numb and was pretty mentally checked out for the whole experience. I remember what happened when reminded but it’s all a blur if I try and go back there on my own. Despite her passing being so peaceful, I can remember repeatedly thinking,”I can’t imagine knowing I’m about to die. I hope I never go this way.” Little did I know, 9 months later I would be diagnosed with the exact same cancer. While I’m currently in remission and hoping for at least 50 more years (I’m 31) before any of this becomes a pressing matter for me, I know the likely hood of me passing slowly and fully aware that it’s happening increased with my diagnosis. So despite knowing that this book would be triggering, my curiosity got the best of me and I wanted a glimpse into those final days. Much to my surprise, I was hardly triggered at all and instead therapeutically taken back into those last 3 weeks with my mother in law. Hearing that her visits from her family member on the other side was a common occurrence gave me almost a sense of excitement instead of anxiety when I imagined myself in between this world and the next, conversing with my loved ones on both sides. Hadley beautifully balanced the seriousness of the situation, especially from her position as a nurse, with the humanity of these tender moments and takes the scary unknown-ness away without depreciating the emotions of the situation.
Profile Image for Ellie.
1,511 reviews392 followers
January 12, 2024
Hadley Vlahos is a hospice nurse (an unusually young one) and she shares vignettes of people with whom she worked, people she provided care for in the last days, and their families. These stories are interspersed with events in Vlahos' own life.

I was continually moved, sometimes to tears, by these stories. As painful as they sometimes were, I also found a strength and solace in them that has impacted on my own feelings about dying.

I'm grateful Vlahos has shared these moments with us.
Profile Image for Ashley Osborn.
63 reviews1 follower
December 3, 2023
I wanted this book to be more about the end of life hospice patients and not an autobiography of a young hospice nurse. We only get a couple pages each chapter that are about the actual patients and their dying moments and what they experience, in between we get the authors life story which I did not find interesting.

I also did not at all like how she talked about other healthcare specialties that are not hospice. As someone in a more critical care setting as a nurse, I found it offensive how she wrote about other healthcare workers. She wrote it as if we have absolutely no compassion for our patients. So many comments made that made it seem like she is the only nurse that actually cares about her patients. Coming from the healthcare field, I found a lot of her stories about other nurses very unbelievable and extremely exaggerated.

I also over did not like her writing style. I understand that she is a nurse that wrote a book but the writing style seemed very juvenile for me.

Overall, the stories and lessons about hospice and end of life are very inspiring and I think would help or teach people that death isn’t always something to fear and it can be done peacefully.
Profile Image for Gary  Beauregard Bottomley.
1,051 reviews638 followers
October 26, 2023
This book insults the reader. Life is finite. There is no in-between no matter how the author forces it into her stories. “Everything happens for a reason” is how the author ends her story as if all of her stories have meaning beyond the quotidian. An imaginary fire in a bed does not portend a real fire in a bed months in the future; that’s just silly. Bestsellers heavily promoted by the NYT such as this book show how people are willing to just believe in fairy-tales if it gives them meaning beyond the day-to-day. After all, everything happens for a reason.
Profile Image for Brandy Staples.
13 reviews2 followers
May 9, 2023
This was such a wonderful book. I won this in a goodreads giveaway and glad I was selected. It brought light to many of the things we question as we near the end of life. This book does deal with End of Life issues, something to keep in mind if that is a topic you aren't comfortable with. I also read a few other reviews for this book and agree that this book is more of a memoir and also taps into the new age/paranormal subjects as well.

I am a stage 4 cancer survivor (going on 19 years NED) being part of the cancer community, I can't tell you how underrated hospice nurses really are. The care and support they offer our loved ones and to family and friends in a time of need is above and beyond. For that I shall be forever grateful.

I will try to review the book without giving away spoilers. The format of the book is the authors personal account of her time as a hospice nurse and why she chose to be one. Each chapter is devoted to a patient that has touched her life in someway. Some of the stories are heart wrenching, some are light hearted and some hold a valuable life lesson, but all are impactful. I was drawn in by the very first page and had a hard time putting the book down.

It was interesting to witness this from the other perspective as I've only seen the receiving end of hospice care. Seeing the battles and courage that hospice nurses go through on a daily bases to give end of life care is not an easy feat by any means. This has given me a whole new respect and insight of the field and how very important they are needed. A really good read!

June 25, 2023
Beautiful work

As I mentioned in a post the other day I have been anxiously awaiting this book. It has spoke to me since I first heard about it being published. When I opened it and the first story was about a woman named Glenda I immediately closed it. Thinking I can’t do this. Not with a woman with my own mama’s name. I even hyperventilated a little. After a bit I persevered and kept reading and kept reading until I finished the book. I have cried silently while sleeping next to my husband. I have cried in the shower. I have cried for the sadness the families have experienced but I have also cried thinking about my mama and her experience. I know she believed in heaven and having a life without the physical disabilities she experienced on earth. I have to believe those she loved who passed before her were there to welcome her. Her passing was peaceful with my dad and I holding her hand. I will always believe I was the privileged one in being with her in her last 24 hours on this earth.

Nurse Hadley and those who chose to spend their life dedicating to making death easier for all involved are heroes. I know the nurse who tended to my mama in her last few hours was wonderful. She explained everything to me, held my hand, and told me what she would do after mama passed. I couldn’t tell you her name but I will never forget her kindness. The way she held my shoulder as I had to sign the paper confirming her passing. Between her and my husband I am not sure I could have ever done that alone.

This book is perfect for anyone who wants to know more about hospice or what those passing experience. Read with tissues.

Five stars is not enough for the gem of a book.
12 reviews1 follower
July 2, 2023
This. Book.

I received this book in the mail last night, and read the last page this morning.

I finished it while soaking in the bathtub, with tears streaming down my face. Man, there's some difficult, beautiful stuff in here.

Can't thank Hadley enough for not only giving us a glimpse into hospice, but also into the mysterious ways of life in general.

This is one of those rare books that will live on my bookshelf in hardcover forever and I will keep extras to gift to friends who might need it along the way.

Five glorious stars!
Profile Image for Sam Elkins.
25 reviews1 follower
July 25, 2023
I can’t remember the last time I cried this much reading a book, but this was so so good in the best way. I have been heavily thinking about going into hospice care after finishing my nursing residency this year and this pretty much solidified that decision for me. This book also did a great job of addressing some of the ugly side of healthcare like shitty management and horrible bias with Medicaid pts among other things.
Profile Image for Aprille in Texas.
44 reviews4 followers
July 18, 2023
What a great read. I’ve thought of becoming a hospice nurse for a while now. Hadley knew at a very young age that that’s what she wanted to do (20.) She has a fitting personality to be a great one. I’ve attended several people passing in home hospice, and agree it’s a much more calming choice than dying in a hospital.

Hadley recounts several patients and how their deaths are all different. The main thing I gathered from it though is the patterns of how they are all the same. I won’t spoil it for you by telling you what those events are.

She is very dedicated to her job. She even goes out to the homeless camp at the beach to help a man there who refused to get any more treatment at a hospital. The events there are heartbreaking.

Profile Image for Maureen Grigsby.
935 reviews
November 15, 2023
This was a fascinating book about working as a hospice nurse. What makes this one unusual is how young the author was. She was under age 30, and was substantially changed from her experiences helping patients transition from this world to another. So many beautiful stories!
36 reviews
July 17, 2023
Excellent

This book was a true page turner, finished in one day. Incredible, personal stories. Highly recommend this well written book.
Profile Image for Andrea.
776 reviews162 followers
November 30, 2023
4.5 Stars ✨

This is a spiritual book. I do not consider myself religious. I loved it anyway.
This is narrated by the author (rarely a good idea). I loved it anyway.
This is brimming with heartbreak. There were tears. I loved it anyway.

I’m betting readers will react to this book in polarizing ways. For me, it brought a sense of some comfort, humanity and a different perspective on end of life. So glad to have read it.
Profile Image for Jenna Streit.
16 reviews1 follower
January 1, 2024
Whew, this book made me reconsider my career choices. Hadley faced a lot of criticism in her choice to be a hospice nurse. Though I've spent the last 8 years working beside healthcare teams, I've never once considered "hospice nurses" less than other nurses. I think they are incredible, and fill an even larger role than nursing. I hope Hadley's book helps bring more light to the incredible role that hospice professionals play in helping us exit the world with dignity and free of suffering.
Profile Image for Laura Kearney.
186 reviews2 followers
June 25, 2023
6 stars. Everyone should read this book. I’m so glad she wrote it 💕
Profile Image for Heidi.
234 reviews
January 6, 2024
Audiobook listen. This is such an impactful read for anyone in healthcare
Profile Image for Megan.
279 reviews
June 19, 2023
I loved this book so much I read it in one weekend, starting as soon as it was delivered to my door. I loved that it was what we'd typically call spiritual without being attached to any one religion. I cried lots of times, so be warned about reading this book in public haha.

I also hate to say I was a little skeptical of a book written by a TikTok star, but I was impressed by the writing and the editing. Very professionally done.

Highly recommend to anyone who has experienced a death of a loved one.
Profile Image for Jessica Bindscheattel.
18 reviews4 followers
May 3, 2023
As most of the readers for The In-Between, I found Nurse Hadely through social media, at the most vulnerable time of my life. I recently had lost my grandfather and I found comfort in her videos knowing that somewhere after this life he went too and was happy. When I saw that she had written a book, I immediately went to look it up to buy it. I found it wasnt out yet, but I felt this pull that I needed to read it right away. I was so happy to find it on Netgalley, and when I was approved for an ARC I was shocked because this genre was way out of my typical reading. But of course, everything happens for a reason and I could not be more grateful that it did happen.

The In-Between is about Hadley Vlahos, a registered hospice nurse. Hadley takes you through the first few years of her beginning career. You read about 12 heartbreaking and heartwarming patients as they come to the end of their life. Each story I found something to personally connect with, I found myself out right balling my eyes out with some stories or tears silently falling down my cheeks. If I could give this book more than 5 stars it would probably be 100, but the highest I have to “rank” would be a 5 stars. This book brings you peace knowing that there might be something on that other side. I highly recommend this book more then i could ever explain
Profile Image for Grace Nettleton.
19 reviews
July 13, 2023
This book was an interesting read. While some of the chapters were captivating, most of them read the same: grumpy patient begins to open up to Hadley and then they die. While I do understand that this is how most hospice care likely happens, I expected more depth in the explanation of what Hadley experienced.

When an author such as Laura Lynne Jackson says this book “dispels the fear around dying” (and this quote is placed on the back cover), I think the book is falsely advertised. In no way do I feel more assured about dying after reading this book. I honestly feel stressed. I think about the cost of my funeral and someone killing themself, like Reggie’s wife. I think a better review for this book would be praise for the light it shines on the importance on hospice and palliative care workers. Hadley is a badass when she stands up to the doctors in the hospital in order to ensure comfort for her patient.

Overall, I would recommend this book to someone because it was an easy, interesting read. But I would warn them to lower their expectations. 2.5 stars.
This entire review has been hidden because of spoilers.
Profile Image for Anne Altman.
610 reviews
June 20, 2023
4.5 stars. Anyone who fears death or wonders about it, which is frankly most of us, should read this book. It’s short but very impactful. The author is a hospice nurse, and she has so much to share about what the final moments of life are like for her patients and how these moments are truly universal regardless of one’s faith, religion, class, etc. I knew nothing about hospice prior to reading this book, but it really opened my eyes to how death should be handled in our society, and how often we get it wrong. The stories she shares of coincidences that are just far too unlikely to actually be coincidences have me the chills. Highly recommend. I will say that the audio is read by the author and while I love the sentiment behind that, I wish a professional narrator had read it, but that’s my only quibble with the book— that and I wanted even more of her stories.
Profile Image for Bridget Fedigan.
17 reviews
July 5, 2023
As someone who plans on becoming a hospice nurse, I truly fell in love with this book and reminded me of why I want to be a hospice nurse. Palliative care is just as important as treating a resident, yet so many dismiss it. Hadley Vlahos, you are my idol and I aspire to be the type of hospice nurse you are. I deeply resonated with this book, especially with dementia patients. Many dismiss dementia patients as “crazy,” yet I have had some residents who truly see and understand the world, even if we ourselves don’t see it. I loved this book so much, what an inspiration to read 🤍🤍
Profile Image for Cynthia.
8 reviews3 followers
July 23, 2023
Saw a few of the author’s TikTok’s advertising this book. It’s not exactly what it was advertised as. Wanted to not finish but did anyways. Do not recommend.
Displaying 1 - 30 of 2,254 reviews

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